| NPI | 1275950164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: MA 292516) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 292516) |
| 207Q00000X Family Medicine (Licence: RI MD18543) | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2024-03-16 |